Active NPI
Maria Rebecca A Talley, PT
- Specialist
- Lagrange, GA
National Provider Identifier
1487733481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PT003839
- Practice address
- 3000 Old West Point Rd
Lagrange, GA 30240-9227 - Phone
- (706) 884-7263
- Fax
- (706) 884-9166
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PT003839 | GA | Primary |
Addresses
Primary practice location
3000 Old West Point Rd
Lagrange, GA 30240-9227
Mailing address
3000 Old West Point Rd
Lagrange, GA 30240-9227
Phone (706) 884-7263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT003839 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1487733481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 OLD WEST POINT RD",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302409227",
"telephone_number": "706-884-7263",
"fax_number": "706-884-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 OLD WEST POINT RD",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302409227",
"telephone_number": "706-884-7263",
"fax_number": "706-884-9166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLEY",
"first_name": "MARIA REBECCA",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "PT003839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.